Ureteroscopy
Ureteroscopy (URS) is a minimally invasive procedure in which a thin, flexible or rigid telescope is passed through the urethra and bladder into the ureter and kidney. A laser (holmium laser lithotripsy) or ultrasonic probe is used to fragment stones into tiny pieces that are either extracted with a basket or pass naturally in the urine. URS is the preferred treatment for ureteric stones and can reach stones in the kidney that cannot be reached by shock wave lithotripsy.
🔬 How the Procedure Is Performed
- 1
Spinal or general anaesthesia is given.
- 2
The ureteroscope is passed through the urethra and bladder into the ureter.
- 3
The stone is identified and fragmented with a holmium laser or ultrasound.
- 4
Stone fragments are extracted with a basket or left to pass naturally.
- 5
A ureteric stent (JJ stent) is often placed at the end to allow the ureter to heal.
- 6
The stent is removed in an outpatient procedure after 2–4 weeks.
✅ Benefits of Ureteroscopy
- ✓High stone-free rate — over 90% for ureteric stones
- ✓No skin incision — completely endoscopic through natural body openings
- ✓Day procedure — most patients go home the same day
- ✓Effective for hard stones that cannot be broken by shock wave therapy
- ✓Access to stones at all levels of the urinary tract
📋 How to Prepare
- Urine culture to exclude active infection before the procedure.
- CT KUB (kidney, ureter, bladder) scan to precisely map stone size, location, and density.
- Stop blood thinners as directed.
- Fast for 6 hours before the procedure.
- Drink plenty of water on the day of the procedure before the fasting period.
⚠️ Possible Risks & Side Effects
- Ureteral injury or perforation — rare with flexible scopes and experienced hands
- Post-procedure urinary tract infection — prevented with pre-operative antibiotics
- Stent discomfort — urinary frequency, urgency, and mild haematuria are common with a stent
- Retained stone fragments requiring a further procedure
- Ureteral stricture in the long term — rare
Your surgeon will discuss all risks with you before the procedure and take appropriate precautions to minimise them.
💊 Post-Procedure Care
- Expect some blood in the urine (haematuria) for 2–5 days — this is normal.
- If a stent was placed: urinary frequency and mild discomfort are expected.
- Drink 2–3 litres of water daily to flush the urinary tract.
- Return for stent removal in 2–4 weeks.
- Stone analysis guides dietary advice to prevent future stones.
❓ Frequently Asked Questions
Will I have a stent after ureteroscopy?
A ureteric stent (JJ stent) is placed in most cases to prevent ureteral swelling and allow stone fragments to pass easily. It is removed 2–4 weeks later in a quick outpatient procedure.
How soon can I return to work after ureteroscopy?
Most desk-job workers return within 2–3 days. Physical work may require 1–2 weeks depending on whether a stent is in place.
How can I prevent kidney stones from coming back?
Drink 2.5–3 litres of water daily, reduce salt and animal protein intake, limit foods high in oxalate (spinach, nuts), and have your stone analysed to guide specific dietary advice.
🏥 Ureteroscopy at Iswarya Hospital
Advanced diagnostic and surgical care for adult and pediatric urological conditions, led by Dr. Prabhu.
ℹ️ This information is for educational purposes only and does not constitute medical advice. Individual treatment plans may vary. Always consult a qualified healthcare professional before making any medical decisions.